N-methyl-D-aspartate (NMDA) receptors are glutamatergic ionotropic receptors involved in excitatory synaptic transmission, synaptic plasticity and excitotoxicity. They are heteromeric complexes of GluN1 combined with GluN2A-D and/or GluN3A-B subunits that are activated by glutamate and glycine. Many allosteric modulators can influence the activity of these receptors including neurosteroids. Pregnanolone sulfáte (3α5βS) is an endogenous neurosteroid that inhibits NMDA receptors in a use-dependent manner and has neuroprotective effect. Binding site for 3α5βS on the NMDA receptor molecule is still not indentified. The aim of my work was to contribute to the identification of the biding site by kinetic analysis of rate of response return from 3α5βS inhibition. Using the point mutation we also attempted to identify the amino acids residues that could be involved in the neurosteroid binding. In order to study the effect of 3α5βS on NMDA receptors the electropfysiological recordings on human embryonic kidney 293T cells expressing recombinant GluN1/GluN2B receptors was performed. We confirm that the effect of 3α5βS on GluN1/GluN2B receptors is voltage-independent. The results of my work indicate that steroids can reach the binding site on the NMDA receptors through the membrane rather than directly from the aqueous...

Herein is reported the synthesis of molecular probes for action of neuroactive steroids in vitro and in living organisms. In the first part, preparation of enantiomeric pregnane steroids is investigated, ultimately resulting into the total synthesis of ent-progesterone. The chirality of the target molecule is introduced by a highly effective organocatalytic asymmetric Robinson annulation. A new method for the sequential construction of five-membered carbocyclic ring is introduced as the key step. This is composed of substrate-controlled copper-catalyzed conjugate addition followed by radical oxygenation and subsequent thermal cyclization employing the persistent radical effect. The synthesis of truncated neurosteroid analogs is described and their biological activity at the NMDA receptor is compared with the native hormone. In the second part, methodology for specific deuterium labeling of both angular methyls of the 5β-pregnane steroid core is explored. Special attention was paid to the Barton-McCombie deoxygenation as the tool for introduction of the last deuterium atom into the methyl group. Both positions were labelled with total of three deuterium atoms in high isotopic purity.

Background: Estrogen has been reported to enhance well-being and quality of life during the climacteric phase. In women with an intact uterus estrogen treatment is always combined with progestins in order to protect the endometrium from hyperplasia and malignancies. However, in certain women the addition of progestins causes cyclicity in negative mood symptoms and physical symptoms similar to those encountered during ovulatory cycles in women with premenstrual dysphoric disorder (PMDD). The ovarian hormones estradiol and progesterone have profound effects on a number of neurotransmitter systems in the brain, such as the gamma aminobutyric acid (GABA) system and the serotonergic system. Progesterone metabolites, such as allopregnanolone and pregnanolone (also referred to as neurosteroids) modify the GABAA receptor in the central nervous system (CNS) and enhance GABAergic inhibitory transmission. Neurosteroid sensitivity in human studies can be studied by saccadic eye movement measurements using pharmacodynamic challenges with pregnanolone. Altered neurosteroid sensitivity has been suggested as a possible contributory factor to the progesterone/progestin-induced adverse mood effects of hormone replacement therapy (HRT). There is also evidence of estrogen treatment affecting the serotonergic system in postmenopausal women, although progestin addition has been less well studied. Aims and method: The aim was to investigate whether the negative mood symptoms experienced during the progestin or progesterone phase of HRT were associated with changes in neurosteroid sensitivity, or changes in platelet serotonin uptake site (transporter) and serotonin2A (5-HT2A) receptor binding. The intention was also to investigate whether hormonal changes during the normal menstrual cycle affect these peripheral serotonergic parameters. Postmenopausal women with climacteric symptoms were given HRT in two randomized, double-blinded, placebo-controlled crossover studies. The women received 2 mg estradiol (E2) continuously during 28- day cycles. Synthetic progestins or natural progesterone were added sequentially during the last 14 days, and compared to a placebo addition. Before treatment, as well as during the last week of each treatment cycle the pharmacodynamic response to pregnanolone was assessed using saccadic eye movement measurements. Throughout the studies daily symptom ratings were made. In the study regarding synthetic progestins, platelet serotonin transporter and 5-HT2A receptor binding were assayed before entering the study, as well as during the last week of each treatment cycle. In the study on reproductive women, blood samples were collected for analysis of platelet serotonin transporter and 5-HT2A receptor binding at six different points in time during the menstrual cycle. Results and conclusion: The addition of synthetic progestins to estrogen treatment increased negative mood symptoms and physical symptoms, whereas positive symptoms decreased. The addition of progestins also increased the sensitivity to pregnanolone. The addition of natural progesterone to estrogen treatment increased the sensitivity to pregnanolone. However, in this study the pregnanolone sensitivity was enhanced also during estrogen treatment. Women expressing cyclicity in negative mood symptoms were more sensitive to pregnanolone than women without symptom cyclicity. Thus, it is evident that mood deterioration during HRT is associated with altered neurosteroid sensitivity. Platelet serotonin transporter and 5-HT2A receptor binding did not change during the different treatment conditions in HRT. Thus, we were unable to explain the negative mood changes of HRT by use of these peripheral serotonergic parameters. In the study on reproductive women however, it was clear that the serotonergic variables did change during the menstrual cycle. Binding to the serotonin transporter was higher in the late follicular phase than in the ovulatory, early luteal or mid-luteal phases. Binding to the 5-HT2A receptor was higher in the early follicular phase and the early luteal phase than in the mid-luteal phase. These findings may provide a link between the ovarian steroids, and the GABAergic and serotonergic neurotransmitter systems, which in turn, could explain part of the specific vulnerability that women have for the development of adverse mood effects during HRT, mood and anxiety disorders and for the deterioration of mood so frequently seen during the luteal phase.

Η νόσος του Parkinson χαρακτηρίζεται από τη βαθμιαία, εκλεκτική νευροεκφύλιση των ντοπαμινεργικών νευρώνων της μελαινοραβδωτής οδού. Η μειωμένη δραστηριοποίηση των ντοπαμινεργικών υποδοχέων που προκαλείται από την ανεπάρκεια ντοπαμίνης τροποποιεί τη λειτουργία των βασικών γαγγλίων και αναστέλλει τα κινητικά συστήματα. Ιδανικό πειραματικό μοντέλο αποτελεί το μοντέλο weaver, το οποίο εμφανίζει το ίδιο μοτίβο νευροεκφύλισης με τους παρκινσονικούς ασθενείς καθώς και περισσότερη από 70% μείωση της ντοπαμίνης στο ραβδωτό σώμα. Το γεγονός πως δεν υπάρχει σήμερα αποτελεσματική θεραπεία που να σταματά ή να αναστρέφει την εξέλιξη της νόσου, δημιουργεί την ανάγκη ανακάλυψης ενός φαρμακευτικού σχήματος το οποίο θα έχει νευροπροστατευτική δράση και θα περιορίζει τις παρενέργειες. Προηγούμενα αποτελέσματα της ομάδας μας δείχνουν σημαντική επιβίωση των ντοπαμινεργικών κυττάρων στο μοντέλο weaver μετά από χρόνια χορήγηση του ενδογενούς νευροστεροειδούς DHEAS, του χημικού αναλόγου του ΒΝΝ-50 (το οποίο δε μεταβολίζεται σε οιστρογόνα) και του φαρμακευτικού συνδυασμού του ΒΝΝ-50 με τη Ν-ακετυλοκυστεΐνη (NAC), με το τελευταίο να επαναφέρει πλήρως τον αριθμό των κυττάρων στη μέλαινα ουσία. Στην παρούσα εργασία θελήσαμε να διερευνήσουμε τους μηχανισμούς μέσω των οποίων επιτυγχάνεται η νευροπροστασία που προκαλεί η συγχορήγηση του συνδυασμού BNN-50/ΝAC. Για το σκοπό αυτό, αξιολογήσαμε την αντιαποπτωτική, καθώς και την αντιοξειδωτική δράση του σχήματος BNN-50/NAC. Οι δύο δείκτες επιλέχθηκαν λαμβάνοντας υπόψιν τον κεντρικό ρόλο του αποπτωτικού θανάτου στη διαδικασία της νευροεκφύλισης, καθώς και το ρόλο του οξειδωτικού στρες στην παθογένεια της νόσου. Τα αποτελέσματα μας υποδεικνύουν πλειοτροπική δράση του φαρμακευτικού συνδυασμού BNN-50/NAC, η οποία εκφράζεται μέσω της ισχυρής αντιαποπτωτικής και αντιοξειδωτικής του δράσης. / Parkinson 's disease is characterized by the progressive, selective neurodegeneration of the dopaminergic neurons of the nigrostriatal pathway. The decreased activation of dopamine receptors caused by insufficient dopamine levels, modifies the function of the basal ganglia circuit and inhibits the mobility systems. The weaver model consists an ideal model for neuroprotection studies, which exhibits the same pattern of neurodegeneration as the parkinsonian patients and more than 70% decrease of dopamine in the striatum. The fact that there is currently no effective treatment to attenuate or reverse the disease progression, creates the need for discovery of a drug combination which will exhibit neuroprotective effect and reduce the side effects. Previous results of our group, have shown a significant survival of dopaminergic neurons in weaver mice after chronic administration of endogenous neurosteroid DHEA-S, the chemical analog BNN-50 (which is not metabolized to estrogens) and the combination of the BNN-50 with N-acetylcysteine (NAC,with the latter combination completely rescuing the number of dopaminergic cells of the substantia nigra. The aim of this study was to investigate the mechanisms of neuroprotection induced by coadministration of combination BNN-50/NAC. For this purpose, we evaluated the possible antiapoptotic and antioxidant action of the BNN-50/NAC combination. Our results suggest a pleiotropic effect of the BNN-50/NAC drug combination, that is expressed through strong antiapoptotic and antioxidant activity.

Cette thèse montre que le GHB et les neurostéroïdes protègent efficacement contre la mort neuronale induite par les facteurs étiologiques de la maladie d'Alzheimer, notamment la sur-expression de l'amyloid precursor protein et le stress oxydant. Nous avons identifié un effet additif du GHB et de l'alloprégnanolone qui pourrait résulter de la combinaison des stimulations partielles évoquées par ces molécules sur l'expression des protéines anti-apoptotiques. L'effet du GHB est bloqué par un inhibiteur de l'aromatase, suggérant que le GHB induirait la neuroprotection via la stimulation de la neurostéroïdogenèse. Pour étudier les effets du GHB et des neurostéroïdes sur l’activité des MMP-2 et MMP-9, qui dégradent les peptides amyloïdes, nous avons optimisé un test enzymatique basé sur l’expression de ces protéases dans la levure. Nos résultats préliminaires ne permettent pas encore de conclure mais leur amélioration et combinaison avec des données de RT-qPCR contribueront à déterminer l'action du GHB et des neurostéroïdes sur l'activité et/ou l'expression des MMP. Notre travail suggère que le GHB et les neurostéroïdes pourraient être associés pour élaborer des stratégies neuroprotectrices contre les pertes neuronales provoquées par la maladie d'Alzheimer. / This PhD work showed that GHB and neurosteroids efficiently protect against nerve cell death caused by Alzheimer's disease etiological factors including amyloid precursor protein overexpression and oxidative stress. Interestingly, we identified an additive action of GHB and allopregnanolone that may result from the combination of partial stimulations of anti-apoptotic protein expression induced by both compounds. GHB protective effect was blocked by aromatase inhibitor, suggesting that GHB may also induce neuroprotection via the activation of neurosteroidogenesis. Finally, we have used a yeast-based MMP activity assay to check whether GHB and neurosteroids regulate MMP-2 and MMP-9 activities which control Aβ peptide degradation. We cannot yet conclude from our preliminary results but their improvement and combination with RT-qPCR analyzes will help to determine the modulatory action of GHB and neurosteroids on MMP activity and/or expression. Together, our data suggest that GHB and neurosteroids may be used to develop combined neuroprotective strategies against neuronal loss in AD.

La sclérose en plaques (SEP) est une maladie auto-immune inflammatoire chronique qui détériore la myéline centrale des patients. Des progrès ont été réalisés dans le traitement de la SEP mais il n'existe pas encore de neuroprotecteurs efficaces contre les dommages axonaux entraînant un lourd handicap. Ce travail de thèse a évalué le potentiel du XBD173, un ligand du translocator protein contrôlant la neurostéroïdogenèse et la neuroinflammation, à améliorer les symptômes dans un modèle de SEP induit par la protéolipide-protéine (souris EAE-PLP) qui mime la forme rémittente-récurrente de la SEP (85% des patients). Nos résultats montrent qu'à faible dose, le XBD173, qui diminue les taux sériques d’interleukines pro-inflammatoires et empêche la répression des marqueurs myélinique et axonal, améliore aussi la symptomatologie des souris EAE-PLP. L'effet bénéfique du XBD173 contre les signes cliniques est reproduit chez les souris EAE-MOG mimant la forme progressive de la SEP. La thèse ouvre des perspectives pour l'élaboration de stratégies efficaces contre la SEP sans induire d'effets secondaires majeurs. / Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease affecting the central myelin. Progress has been made for MS treatment, but effective neuroprotective drugs against MS-evoked axonal damages and severe disability are still missing. This thesis assessed the potential of XBD173, a ligand of the translocator protein controlling neurosteroidogenesis and neuroinflammation, to improve symptoms in the proteolipid protein-induced MS model (EAE-PLP mice) that mimics the relapsing-remitting form affecting 85% of MS patients. Our results show that XBD173 at low dose decreases serum levels of pro-inflammatory interleukins, prevents the repression of myelin and axonal markers, and also ameliorates clinical deficits in EAE-PLP mice. The beneficial effect of XBD173 against clinical symptoms was also observed in the EAE-MOG mice mimicking the progressive MS. Promising perspectives are open for the development of effective strategies against MS with little or no serious side effects.

Les lésions nerveuses périphériques (LNP) ont des origines variées. Elles peuvent être causées par un traumatisme, une inflammation, une ischémie mais également par la compression de nerfs par une tumeur. Ces lésions traumatiques entrainent une perte sensorielle mais aussi une atteinte motrice pouvant avoir une incidence importante sur la vie des patients et leurs familles. De nombreux progrès ont été réalisés dans le traitement des LNP ces dernières années, cependant, la récupération des patients reste incomplète. Ainsi, l’amélioration du pronostic clinique demeure un défi pour les chercheurs et les cliniciens avec l’utilisation de nouvelles techniques et produits thérapeutiques. Ceci m’a conduit pour ma thèse à utiliser une nouvelle approche avec deux types de greffons combinés avec plusieurs stades de lésion du nerf donneur, mais également à tester le potentiel thérapeutique de petites molécules de types neurostéroïdes, ligands TSPO et activateurs de canaux potassiques afin d’étudier les effets sur la neurorégénération et la neuroprotection lors d’une lésion traumatique. Ainsi, ma thèse se compose de deux parties, faisant appel à deux modèles expérimentaux de rats. 1) Afin de déterminer les meilleures conditions de lésion du nerf donneur lors de la greffe, une neurorrhaphie entre le nerf donneur et la greffe a été réalisée avec deux types de greffons (frais ou pré-dégénérés). Un marquage des neurones par un traceur rétrograde, l’analyse des axones myélinisés et l’évaluation des potentiels d’actions ont été réalisés pour étudier la neuroprotection et la neurorégénération. Cette approche a permis de montrer une régénération axonale efficace à condition que la partie axonale fournie par le nerf donneur atteigne 50 % du nombre total d’axones. De plus, l’utilisation du greffon pré-dégénéré a montré un effet bénéfique en potentialisant le processus de neurorégénération. 2) Dans le but d’étudier l’effet de l’administration de petites molécules telles que la progestérone, la Nestorone, l’étifoxine et les activateurs des canaux potassiques Kv7.2/7.3 sur la neuroprotection, la régénération axonale et les fonctions de récupération, on a utilisé un modèle de lésion par compression du nerf spinal cervical. Les analyses histologiques mentionnées ci dessus, la mesure des potentiels évoqués et des tests de comportements sensori-moteurs ont été effectués pour étudier la neuroprotection, la neurorégénération et les fonctions de récupération. La progestérone et la Nestorone ont montré des effets bénéfiques sur la neuroprotection à court terme, mais également sur la neurorégénération et la récupération fonctionnelle à long terme après une lésion nerveuse. D’une manière intéressante, l’action seule de l’étifoxine améliore la récupération fonctionnelle motrice tandis que le GRT12 seul a plutôt une action bénéfique sur la récupération sensitive. Les composés de synthèse associant les propriétés de ligands TSPO d'activateurs des canaux Kv7.2/7.3 ont montré des effets sur la récupération fonctionnelle à la fois motrice et sensitive. Notre étude met en évidence qu’une neurorrhaphy réalisée avec une lésion de 50% du nerf donneur est la meilleure condition pour la neurorégénération. Elle a également permis de vérifier l’avantage de l’utilisation d'un greffon nerf pré-dégénéré pour améliorer le processus de neurorégénération. Nous avons démontré l’action thérapeutique de la progestérone et de la Nestorone sur la neuroprotection et neurorégénération, mais également celle des nouveaux composés synthétiques (ligand TSPO combiné à l’activateur Kv7.2/7.3) sur la récupération sensori-motrice. / Peripheral nerve injury (PNI) results from multiple causes, including trauma, inflammation, ischemia and tumor compression. Dysfunction of affected muscles and sensory deprivation caused by PNI result in huge obstacles for suffering patients and their families. Even though many achievements for PNI treatment have been realized during the last decades, poor clinical prognosis remains a challenge for researchers and clinicians. This prompted me to explore new approaches for nerve repair by using two different types of nerve grafts associated with several nerve injuries of donor nerve, but also investigate the therapeutic potential of several small molecules including neurosteroids, TSPO agonist ligands and potassium channel activators for promoting neuroprotection and neuroregeneration. My thesis is divided into two parts and makes use of two experimental rat models. The major aims were : 1) To determine the optimal injury condition of a donor nerve for end-to-side neurorrhaphy by using a sciatic end-to-side neurorrhaphy model with different types of autologous nerve grafts (fresh or predegenerated). Neuronal retrograde labeling, analysis of myelinated axons and the evaluation of action potentials were performed to evaluate neuroprotection and neuroregeneration. This approach showed that effective axonal regeneration into a nerve graft occurred only when axonal resources supplied by the donor nerve reached 50% of its total number of axons. In addition, the use of a predegenerated nerve graft was beneficial for neuroregeneration by improving the environment of the nerve pathway. 2) To investigate the efficacy of the administration of small molecules including progesterone, Nestorone, etifoxine and Kv7.2/7.3 channel activators for neuroprotection, axonal regeneration and functional recovery. For these studies, we developed a cervical spinal nerve crush injury model. The same histological analysis mentioned above, measures of evoked potentials and motor or sensory behavioral tests were performed to evaluate neuroprotection, neuroregeneration and functional recovery. Progesterone and Nestorone showed benefits on neuroprotection at early stages and on neuroregeneration and functional recovery at later stages after nerve injury. Interestingly, the mono-therapy of etifoxine promoted motor functional recovery while the mono-therapy of GRT12 was beneficial for sensory functional recovery. The synthetic compounds combining TSPO ligand and Kv7.2/7.3 channel activator properties promoted both motor and sensory functional recovery. In conclusion, our study revealed that 50% axotomy of a donor nerve in the end-to-side neurorrhaphy paradigm is the optimal condition for neuroregeneration. We also verified the advantage of using predegenerated instead of a fresh nerve graft to improve the regenerative environment. We also demonstrated the effectiveness of progesterone and Nestorone in neuroprotection and neuroregeneration, and that new synthetic compounds with TSPO ligand and Kv7.2/7.3 channel activator properties promoted motor and sensory recovery.

Les neurostéroïdes sont des composés endogènes qui peuvent moduler la transmission synaptique et avoir un effet neuroprotecteur dans les maladies neurodégénératives. Les systèmes régulant leur biosynthèse ne sont pas connus mais la première étape de celle-ci peut être régulée par la protéine TSPO. Cette protéine mitochondriale facilite le transport du cholestérol vers l’intérieur de la mitochondrie pour y être métabolisé en prégnénolone. Ce stéroïde est le précurseur principal de la biosynthèse des neurostéroïdes et l’utilisation in vitro de ligands du TSPO permet d’augmenter sa sécrétion. Dans ce travail de thèse, nous avons ainsi cherché à développer de nouvelles familles de ligands solubles du TSPO augmentant la sécrétion de prégnénolone. Le développement de ces nouvelles familles a nécessité la réalisation d’une méthodologie de synthèse faisant intervenir une réaction de cyclisation pallado-catalysée de type Buchwald-Hartwig. Une étude de solubilité des composés synthétisés a été effectuée expérimentalement, leur activité a été évaluée par des méthodes fonctionnelles et leur effet neuroprotecteur a été testé sur un modèle cellulaire de la maladie d’Alzheimer. / Neurosteroids are endogenous compounds which can alter the synaptic transmission and enhance neuroprotection in neurodegenerative diseases. The systems that regulates their biosynthesis are not described but its first step ca be regulated by the TSPO. This mitochondrial protein facilitates the transport of cholesterol to the mitochondrial matrix to be metabolized in pregnenolone. This steroid is the precursor of neurosteroid biosynthesis and in vitro use of TSPO ligands induces its secretion. For this project, we looked forward to develop new families of soluble TSPO ligands that can increase pregnenolone production. The access to 3-amino-3,4-dihydroquinolin-2-ones required the establishment of a synthesis methodology of a palladium-catalyzed cyclization following Buchwald-Hartwig amination. A solubility study of synthesized compound was performed, their activity was established based on functional assays and their neuroprotective effect was evaluated on a cellular model of Alzheimer disease.